Ghulam Mohyuddin - Academia.edu (original) (raw)

Papers by Ghulam Mohyuddin

American Journal of Hematology

Treatment at academic cancer centers (ACs) is associated with improved survival across hematologi... more Treatment at academic cancer centers (ACs) is associated with improved survival across hematologic malignancies, though the benefit in multiple myeloma (MM) has not been examined. This study aims to evaluate survival outcomes at Commission on Cancer accredited ACs compared to non‐academic centers (NACs) for patients receiving MM‐directed therapy. The National Cancer Database (NCDB) was used to identify demographics and overall survival (OS) of MM patients diagnosed from 2004 to 2017 and to compare outcomes by facility type. Survival analysis was repeated in a propensity score matched cohort, with NACs matched 1:1 to ACs by age, race, comorbidity score, insurance, year of diagnosis, distance traveled, and income. Of 163 375 MM patients, 44.5% were treated at ACs. Patients at ACs were more likely to receive MM‐directed therapy compared to NACs (81% vs. 73%, p < .001). For patients receiving treatment, median OS at ACs was 71.3 months versus 41.2 months at NACs (p < .001). When a...

Additional file 2: Table S2. Assessment of bias risk in each study

ADVANCES IN CELL AND GENE THERAPY, 2021

Cureus, 2021

Audience response systems engage learners and facilitate the assimilation of the material. We ass... more Audience response systems engage learners and facilitate the assimilation of the material. We assessed whether incorporation of one system into a resident case conference would increase retention of information and attentiveness. Pre-tests were administered prior to case conferences. The University Hospital incorporated Poll Everywhere into a conference and the Veterans Administration hospital did not. Participants rated self-perceived attentiveness and completed a post-test following conference. There was an increase in post-test scores compared to pre-tests. There was no significant difference in self-perceived attentiveness or post-test scores between sites. The use of audience response did not increase retention of material or perceived attentiveness when incorporated into the conference.

Journal of electrodiagnosis and neuromuscular diseases, Dec 31, 2022

Carpal tunnel syndrome (CTS) is the most common peripheral neuropathy affecting the upper limbs. ... more Carpal tunnel syndrome (CTS) is the most common peripheral neuropathy affecting the upper limbs. Various treatment methods exist for this disease, but only a few reports have compared the effects of various treatments using objective indicators. This study analyzed the changes in electrophysiological parameters after carpal tunnel release. Methods: In patients planning to undergo surgical treatment for CTS, electrophysiological studies, including nerve conduction studies and electromyography (EMG), of both upper extremities were performed before and 6 to 8 weeks after mini-open transverse carpal ligament release and median nerve neurolysis. Results: After surgical intervention, the onset latency and amplitude of the sensory nerve action potential (SNAP) and the onset latency of the compound muscle action potential (CMAP) of the median nerve improved. Additionally, the grade of abnormal spontaneous activity in needle EMG of the abductor pollicis brevis (APB) and the severity of the electrodiagnostic study results significantly decreased after the intervention compared to the initial evaluation. Conclusion: This study shows that the onset latency of SNAP and CMAP, the amplitude of SNAP of the median nerve, and EMG findings in the APB can be useful electrodiagnostic parameters for postoperative monitoring in CTS patients.

Journal of entomology and zoology studies, 2020

Ants (Hymenoptera: Formicidae) are species rich and ecologically leading of all eusocial inverteb... more Ants (Hymenoptera: Formicidae) are species rich and ecologically leading of all eusocial invertebrates. Cosmopolitan distribution across the tropical, subtropical and temperate zoogeographic regions. They are excellent bio indicator, predator, scavengers, omnivores, granivores and herbivores having good mutualistic behaviour with flora and fauna constitute greater part of biomass 16-20%. Ants were collected from diverse vicinities of District Faisalabad, Punjab, Pakistan by using aspirator belongs to 6 genera included 8 species Bingham taxonomic keys and other reliable literature were used for identification. All of these types are new to ant creatures of Faisalabad namely: are described for the first time from this District. Following genera were identified Pheidole westwood, 1840, Monomorium Mayr, 1855 Meranoplus Smith, 1854, Solenopsis westwood, 1840, Atopomyrmex Andr, 1889, Crematogaster Lund, 1832. Taxonomic keys are also provided for better identification.

The purpose of this study was to evaluate the diversity trends in dermatology randomized controll... more The purpose of this study was to evaluate the diversity trends in dermatology randomized controlled trials over time. A systematic review was conducted to identify all prospective randomized controlled trials published from January 1, 2005 until August 26, 2020 that focused on psoriasis, lichen planus, alopecia areata, seborrheic dermatitis, vitiligo, acne/acneiform eruptions, eczema, and atopic dermatitis. Table S1 shows our search strategy. A total of 9518 articles were found, and 1504 manuscripts met inclusion criteria. Figure S1 demonstrates the flow diagram of how we narrowed down our included studies. We found the inclusion of diverse individuals in dermatology randomized controlled trials has improved over time but is still not reflective of the general population.

BMC Cancer, 2021

Background Despite advances in treatment, multiple myeloma (MM) remains incurable and results in ... more Background Despite advances in treatment, multiple myeloma (MM) remains incurable and results in significant morbidity and mortality. Further research investigating where MM patients die and characterization of end-of-life hospitalizations is needed. Methods We utilized the National Inpatient Sample (NIS) to explore the hospitalization burden of MM patients at the end of their lives. Results The percent of patients dying in the hospital as a percent of overall MM deaths ranged from 54% in 2002 to 41.4% in 2017 (p < 0.01). Blood transfusions were received in 32.7% of these hospitalizations and infections were present in 47.8% of patients. Palliative care and/or hospice consultations ranged from 5.3% in 2002 to 31.4% in 2017 (p < 0.01). Conclusion Our study demonstrates that patients with MM dying in the hospital have a significant requirement for blood transfusions and have a high infection burden. We also show that palliative care and hospice involvement at the end of life has...

European Journal of Cancer, 2021

Introduction: Chimeric antigen receptor T-cell therapy (CART) has revolutionised treatment of hae... more Introduction: Chimeric antigen receptor T-cell therapy (CART) has revolutionised treatment of haematological malignancies; however, current reporting uses a modified intention-to-treat analysis (mITT) which overestimates efficacy. We assessed what proportion of CD19 and B-cell maturation antigen (BCMA) CART trials report the number of patients not receiving CART after being enrolled by performing metaanalysis of the mITT and intention-to-treat (iTT) overall response rate (ORR). Methods: PubMed/MEDLINE, EMBASE and Cochrane databases were searched. All prospective clinical trials of CD19 and BCMA-targeting CART enrolling two or greater patients from 1st January 2013 to 1st November 2020 were included. Results: A total of 28 BCMA CART and 74 CD19 CART trials were identified. These included 10 BCMA CART (35.7%) and 52 (70.2%) CD19 CART trials reporting total number of patients enrolled and number of patients treated with CART. For this cohort of trials, the mITT ORR for BCMA CART was 78.0% (95% confidence interval (CI) Z 67.0e89.0%), and the iTT ORR was 70.0% (95% CI Z 59.0e80.0%). For CD19 leukaemia CART, the mITT ORR was 87.2% (95% CI Z 83.1e91.2), and the iTT ORR was 74.9 (95% CI Z 64.8 e85.0). For CD19 lymphoma CART, the mITT ORR was 70.7% (95% CI Z 63.9e77.5), and the iTT ORR was 58.7% (95% CI Z 49.7e67.7).

$Research paper thumbnail of Outcomes of VD-PACE With Immunomodulatory Agent as a Salvage Therapy for Relapsed/Refractory Multiple Myeloma$

Clinical Lymphoma Myeloma and Leukemia, 2020

The number of therapeutic options for patients with relapsed/refractory multiple myeloma (RRMM) h... more The number of therapeutic options for patients with relapsed/refractory multiple myeloma (RRMM) has increased significantly. We treated 30 patients with RRMM with VD-PACE D IMiD as salvage therapy followed by high-dose chemotherapy and autologous stem-cell transplantation. VD-PACE D IMiD is an effective and tolerable salvage treatment for RRMM, with an impressive response rate in pretreated RRMM. Background: Aggressive relapsed/refractory multiple myeloma (RRMM) often requires salvage cytotoxic chemotherapy. We evaluated the efficacy and toxicity of VD-PACE (bortezomib, dexamethasone, cisplatin, doxorubicin, cyclophosphamide, etoposide) with an immunomodulatory agent (IMiD) in RRMM. Patients and Methods: We retrospectively reviewed the effectiveness and tolerability among 30 patients with RRMM receiving ! 1 cycle of VD-PACE þ IMiD between January 2012 to April 2019. Results: Of 30 patients, 26 (86%) had myeloma double refractory to protease inhibitors and IMiDs, and had received a median of 3 lines prior of therapy. The overall response rate was 67.7%, 13% patients experienced complete remission or better, and 13% experienced very good partial response. Median progression-free and median overall survival were 11 and 26 months, respectively. The most common grade 3 or higher adverse events were hematologic events, which were manageable. Conclusion: VD-PACE þ IMiD is an effective and tolerable salvage treatment for RRMM, with an impressive response rate in pretreated RRMM.

Journal of Clinical Oncology, 2020

e16802 Background: PARP inhibitor (PARPi) has recently been approved for various cancers. However... more e16802 Background: PARP inhibitor (PARPi) has recently been approved for various cancers. However, trials have mostly recruited pts with germline BRCA (gBRCA) mutations, and it is unclear whether PARPi have similar efficacy in pts with somatic BRCA (sBRCA) mutations. We aimed to determine the efficacy of PARPi in pts with sBRCA mutations. Methods: Per PRISMA guidelines, systematic review of PubMed, Embase, Cochrane RCT, and Web of Science Collection was performed from inception thru Jan 2020 to identify studies. Our inclusion criteria were clinical trials and retrospective studies that reported use of PARPi in pts with both s and g BRCA mutations. We performed a meta-analysis comparing overall response rate and PFS with PARPi in pts with s versus g BRCA mutations. Results: After screening, 18 studies met our criteria for including both s and g BRCA mutations. Only 8 studies reported response rates for both s and g BRCA mutations (Table). In those studies, 24 out of 43 pts with sBRCA...

Journal of Cancer Education, 2020

Most oncology education is provided to residents on an inpatient oncology service, with limited o... more Most oncology education is provided to residents on an inpatient oncology service, with limited outpatient exposure. There exists considerable need to develop effective education strategies to teach resident physicians basic concepts in oncology. We created a 2-hour small-group interactive workshop, using interactive cases, followed by a number of questions regarding curability, survival, and possible treatment options. All residents were asked to fill out optional questionnaires before and after this workshop. A total of 64 residents participated in this study with an average of 16 residents per session. Significant deficits in knowledge were identified, and prognosis was estimated correctly by 40% of residents when presented with a variety of clinical scenarios. We demonstrated an increase in comfort level in basic oncology concerns, comfort level at estimating prognosis, and managing toxicity based on pre-and post-level testing. Our results confirm that the oncology inpatient rotation may not be adequate in educating residents. The format of our workshop demonstrates that it is possible to create and implement a focused intervention with fairly limited resources. This can serve as a platform for evaluation of oncology medical education of internal medicine residents at other institutions.

Gastroenterology, 2020

Introduction Ranitidine is a histamine H-2 receptor antagonist that is used for the prophylaxis a... more Introduction Ranitidine is a histamine H-2 receptor antagonist that is used for the prophylaxis and treatment of gastrointestinal disorders associated with gastric acid secretion. Regulatory agencies throughout the world have asked for voluntary recall of all ranitidine products given reports of contamination with N-nitrosodimethylamine (NDMA) which is classified as a probable human carcinogen by the International Agency for Research on Cancer (IARC). We aim to study if ranitidine use leads to an increased risk of various cancers using a large population-based database. Methods The Explorys database (IBM, New York) is a source of longitudinal real world deidentified data collected from electronic medical records from over 40 health systems nationwide. It allows for the assessment of temporal information about risk factors and occurrence of specific diseases based on SNOMED code criteria. We queried the Explorys database by searching for patients on the drug ingredient "ranitidine" use as an index event and assessing for all subsequent diagnoses of cancer from 1999-2019. We used two control populations: patients using an alternate H2 blocker (famotidine), and general population that did not use either H2 blocker. Statistical analysis was performed using SPSS 26 (Armonk, NY). Results The Explorys database contained over 65 million patients at the time of our search. In our analyses, 1.62 million users of ranitidine were identified, 3.37 million users of famotidine, and 59.63 million individuals who did not use either H2 blocker. Users of ranitidine and famotidine when compared to the general population, and users of famotidine when compared to ranitidine, were older (p<0.001), smokers (p<0.001), obese (p<0.001), had liver cirrhosis (p<0.001), a history of alcohol use (p<0.001), and a family history of cancer (p<0.001). Users of ranitidine were more likely to have a diagnosis of GERD compared to users of famotidine (p<0.001). Baseline characteristics of each population are listed in Table 1. Overall, incidence of cancer was 26.4%, 31.1% and 13% in ranitidine, famotidine, and general population, respectively.Incidence of specific cancers is lower in the ranitidine users compared to famotidine users (Figure 1). Among subjects without risk factors including smoking, obesity, alcohol use, family history, cirrhosis and GERD, the risk of all cancers (excluding non-melanoma skin cancers) was identical for ranitidine and famotidine (OR=1, CI=1.01-1.02, p=0.001). Conclusion In this large cohort study of 65 million adults in the United States, we did not see any evidence of increased risk of various cancers in ranitidine users above that of users of a comparable H2 blocker such as famotidine. Users of ranitidine were more likely to have a diagnosis of cancer compared to the general population but were also more likely to have other risk factors for cancer.

Biology of Blood and Marrow Transplantation, 2020

We performed a retrospective analysis of 806 pts with newly diagnosed MM who underwent ASCT at ou... more We performed a retrospective analysis of 806 pts with newly diagnosed MM who underwent ASCT at our institution. Pts were stratified as high risk in the presence of t(4;14), t(14;16), gain 1q or del17p. Correlation with PFS and OS was conducted by univariable and multivariable analyses. Log-rank test was used to compare PFS and OS. Results: 16% of pts were non-white. High risk comprise 30.4% of total pts with 23.2% non-white. PFS was similar in both non-white and white pts with a HR=1.02 (0.82-1.28; p=0.86). There was no statistically significant different in OS from time of transplant (HR=1.09 (0.81-1.47) p value = 0.57)). Upon further stratification by standard risk v/s high risk, outcomes in non-whites and whites remain similar (HR=1.05 (0.64-1.71; p value 0.86) for PFS and HR=1.06 (0.55-2.05), p=0.86 for OS) Discussion: Inferior outcomes in racial minorities is a concern in all malignancies, including MM despite advances in therapeutics. Under-representation in clinical trials and lack of access to care have been touted as potential causes. Our experience suggests that non-white pts do as well as white pts if they have equal access to treatment, and this is seen even in patients with high risk cytogenetics. There is a compelling need to identify obstacles to appropriate care for these minorities and further bridge these gaps in outcomes. Further efforts are also needed to evaluate genomic differences in different ethnicities to further personalize induction/maintenance regimens.

European Journal of Haematology, 2019

ObjectiveAscertain the benefit of prophylactic antibiotics for patients with newly diagnosed mult... more ObjectiveAscertain the benefit of prophylactic antibiotics for patients with newly diagnosed multiple myeloma (MM), given that clinical trials evaluating this have had conflicting results.MethodsWe performed a systematic review and meta‐analysis evaluating the use of prophylactic antibiotics in patients with MM and its impact on infection risk and mortality.ResultsAcross three included studies, a total of 664 patients received antibiotics and 650 patients received no antibiotics. The overall incidence of infection within 3 months was lower for antibiotic group compared to placebo (18.4% vs 23.4%, RR: 0.79, 95% CI 0.62‐1.00, P = .05, I2 = 6.5%). There was no difference in mortality in the first 3 months (1.5% vs 3.5%, RR: 0.47, 95% CI 0.17‐1.27, P = .60, I2 = 28.1%).ConclusionAntibiotic prophylaxis for a finite duration can decrease the overall incidence of infection within the first 3 months following diagnosis. This does not lead to a decrease in mortality. Further data on antibiot...

International Journal of Neuroscience, 2019

Hematology/oncology and stem cell therapy, Jan 19, 2017

Surveillance scans after autologous stem cell transplant (auto-HCT) for patients with relapsed/re... more Surveillance scans after autologous stem cell transplant (auto-HCT) for patients with relapsed/refractory (RR) diffuse large B Cell lymphoma (DLBCL) have no proven survival benefit. We studied survival differences among patients with RR DLBCL post auto-HCT whose recurrences were detected clinically versus with routine surveillance imaging. Among the 139 patients with RR DLBCL that underwent auto-HCT from 2000 to 2014 at our institution, 37 relapsed: 21 clinical and 16 radiological. The median time to progression was 167 days for the clinical cohort and 565 days for the radiological cohort (p = 0.03), and median overall survival (OS) was 587 days and not reached, respectively (p = 0.006). Most patients with relapsed DLBCL after auto-HCT were diagnosed clinically and were likely to be detected earlier and have a shorter OS. Relapse in patients with aggressive disease will likely be detected when clinically apparent, and the outcome of these patients is independent of the way the relap...

Leukemia & lymphoma, Feb 3, 2017

Case Reports in Hematology, 2016

Primary myelofibrosis (PMF) commonly results in extramedullary hematopoiesis (EMH) in the spleen ... more Primary myelofibrosis (PMF) commonly results in extramedullary hematopoiesis (EMH) in the spleen and liver as well as a variety of other organs. We present a first report of a unique presentation of PMF in a liver transplant recipient patient as EMH in the transplanted liver graft. A 76-year-old man with history of cryptogenic cirrhosis received cadaveric liver transplantation in 1996. He maintained a normal graft function and stable hematologic parameters until 2013 when he presented with anemia and progressive fatigue. Extensive work-up did not identify the etiology of the recent decline in his hemoglobin; thus a liver biopsy was done which showed findings of EMH within the sinusoids with increased megakaryocytes, some with atypical morphology. A BM biopsy revealed a hypercellular marrow, moderately increased reticulin fibrosis, and features consistent with primary myelofibrosis. Abdominal imaging showed a normal-size spleen and did not identify any sites of EMH outside of the liv...